DE69725388T2 - Catheter with provisional vena cava filter - Google Patents

Catheter with provisional vena cava filter Download PDF

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Publication number
DE69725388T2
DE69725388T2 DE69725388T DE69725388T DE69725388T2 DE 69725388 T2 DE69725388 T2 DE 69725388T2 DE 69725388 T DE69725388 T DE 69725388T DE 69725388 T DE69725388 T DE 69725388T DE 69725388 T2 DE69725388 T2 DE 69725388T2
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Germany
Prior art keywords
catheter
last
support part
tubular body
engagement
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Expired - Lifetime
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DE69725388T
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German (de)
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DE69725388D1 (en
Inventor
Tjeerd Homsma
Alexander Christiaan Boudewijn
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Cordis Europa NV
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Cordis Europa NV
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/01—Filters implantable into blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/01—Filters implantable into blood vessels
    • A61F2/011—Instruments for their placement or removal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/01—Filters implantable into blood vessels
    • A61F2002/016—Filters implantable into blood vessels made from wire-like elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/01—Filters implantable into blood vessels
    • A61F2002/018—Filters implantable into blood vessels made from tubes or sheets of material, e.g. by etching or laser-cutting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028—Shapes in the form of latin or greek characters
    • A61F2230/005—Rosette-shaped, e.g. star-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0071—Three-dimensional shapes spherical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0059—Additional features; Implant or prostheses properties not otherwise provided for temporary

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)

Description

Die Erfindung bezieht sich auf einen Katheter mit einem temporären Vena-cava-Filter, welcher aus einem röhrenartigen Grundkörper mit einem proximalen und einem distalen Ende besteht. Mit dem Grundkörper verbunden ist ein Filterelement, welches mehrere biegsame Leisten (bzw. Bänder, bzw. Drähte) umfasst, die äquidistant zueinander um den Umfang des Grundkörper herum angeordnet und mit den gegenüberliegenden Enden jeweils mit einem vorderen bzw. hinteren Trageteil verbunden sind. Die Trageteile sind relativ zueinander beweglich, so dass sie aufeinander zu und wieder voneinander weg bewegt werden können. In dem Zustand, in dem sie voneinander weg bewegt wurden, sind die biegsamen Leisten gestreckt und liegen an dem Grundkörper des Katheters an, so dass dieser in den Körper eines Patienten eingeführt werden kann. Sobald das Filterelement in die erforderliche Position innerhalb der Vena cava gebracht wurde, werden die Trageteile durch Ausdehnungsmittel aufeinander zu bewegt, wodurch sich die biegsamen Leisten nach außen krümmen, bis sie die Wand der Vena cava berühren. Die nach außen gekrümmten Leisten bilden folglich einen Filter, der verwendet werden kann, um Thromben aufzufangen.The invention relates to a Catheter with a temporary Vena cava filter, which consists of a tubular body a proximal and a distal end. Connected to the body is a filter element, which comprises several flexible strips (or tapes, or wires), the equidistant arranged to each other around the circumference of the base body and with the opposite Ends each connected to a front or rear support part are. The support members are movable relative to each other, so that they can be moved towards and away from each other. In the state in which they were moved away from each other are the flexible strips stretched and lie on the base of the Catheter so that it can be inserted into a patient's body can. Once the filter element is in the required position within the Vena cava has been brought up, the supporting parts by expansion means moves towards each other, causing the flexible strips to curve outwards until they touch the wall of the vena cava. The outward curved Bars therefore form a filter that can be used to catch thrombi.

Solch ein Katheter mit einem Vena-cava-Filter wird üblicherweise einige Zeit im Körper des Patienten belassen. Während dieser Zeit kann die Gefäßinnenwand (tunica intima) der Vena cava über die Leisten wachsen, die sie berührt, so dass der Filter im Prinzip nicht mehr entfernt werden kann, ohne die Gefäßinnenwand zu beschädigen.Such a catheter with a vena cava filter is usually some time in the body of the patient. While the inner wall of the vessel (tunica intima) of the vena cava above the groins grow that touches them so that in principle the filter can no longer be removed without the inner wall of the vessel to damage.

Das Ziel der Erfindung ist es deshalb, einen Katheter mit einem temporären Vena-cava-Filter bereitzustellen, der diese Nachteile nicht hat.The aim of the invention is therefore a catheter with a temporary To provide a vena cava filter that does not have these disadvantages.

Dieses Ziel wird mit einem Katheter nach Anspruch 1 erreicht. Durch das Bewegen der Eingreifmittel von der Eingreifposition in die Freigabeposition ist es möglich, die Leistenenden zu lösen, ohne auf die Leisten selbst Kraft auszuüben. Eine Beschädigung der Gefäßinnenwand, die um die Leisten herum gewachsen ist, wird daher auf zuverlässige Weise verhindert.This is done with a catheter reached according to claim 1. By moving the means of intervention from the engagement position in the release position it is possible to Loosening lasts without exerting any strength on the lasts themselves. Damage to the Inner vessel wall, that has grown around the ledges is therefore reliably prevented.

Bei den bekannten Kathetern ergibt sich die Beschädigung dadurch, dass die Leistenenden durch eine in axialer Richtung auf die Leistenenden einwirkende Zugkraft gelöst werden müssen. Diese Zugkraft in axialer Richtung bewirkt eine nach innen gerichtete Kraft, welche auf die gebogenen Abschnitte der Leisten einwirkt, wodurch die Leisten aus der Gefäßinnenwand gelöst werden können. Da bei dem erfindungsgemäßen Katheter keinerlei Zugkräfte auf die Leisten einwirken, bleibt jegliche Beschädigung aus, wenn der Katheter entfernt wird. Ein Gerät, welches die im Oberbergriff von Anspruch 1 genannten Eigenschaften aufweist, ist in Dokument FR-A-2652267 offenbart.In the known catheters yourself the damage in that the ledge ends by an in the axial direction the traction ends acting on the last must be released. This tensile force in axial Direction causes an inward force that acts on the Curved sections of the strips act, causing the strips to come off the inner wall of the vessel solved can be. Since in the catheter according to the invention no traction Any damage to the groin is avoided when the catheter Will get removed. A machine, which the properties mentioned in the preamble of claim 1 is disclosed in document FR-A-2652267.

Ein geeignetes Ausführungsbeispiel des erfindungsgemäßen Katheters ist in Anspruch 2 beschrieben. Nach dem Entfernen der Sperrmittel können die Leistenenden aus der Fassung bewegt werden, ohne dass eine signifikante Kraft in Achsenrichtung ausgeübt wird.A suitable embodiment of the catheter according to the invention is described in claim 2. After removing the blocking agent can the lasts of the last are moved out of the socket without any significant Axial force applied becomes.

Zusätzlich wird vorzugsweise die in Anspruch 3 dargelegte Maßnahme angewendet. In diesem Fall können die Sperrmittel unmittelbar auf die Leistenenden einwirken.In addition, the measure set out in claim 3 applied. In this case, you can the blocking means act directly on the lasts of the last.

Mit der in Anspruch 4 dargelegten Maßnahme wird erreicht, dass beim Bewegen der Sperrmittel von der Eingreifposition in die Freigabeposition das Leistenende aus der Fassung gezogen wird, so dass es zwangsweise abgelöst wird.With the set out in claim 4 measure is achieved when moving the locking means from the engaged position pulled the last end of the last out of the socket into the release position so that it is forcibly replaced.

Bei Anwendung der in Anspruch 5 dargelegten Maßnahme müssen nur begrenzte Kräfte auf die Sperrmittel angewendet werden.When using the set out in claim 5 measure have to limited powers to be applied to the blocking agents.

Ein anderes geeignetes Ausführungsbeispiel wird in Anspruch 6 beschrieben. Im Eingreifzustand können die zum Ende hin an Durchmesser zunehmenden Enden der Leisten den schmalen Teil des Raumes, der nicht von dem Sperrmittel eingenommen wird, nicht passieren, so dass die Leistenenden direkt im Trageteil eingeschlossen sind. Durch Zurückziehen der Sperrmittel wird ein größerer Raum geschaffen, durch den die Leistenenden ungehindert hinaus gelangen können.Another suitable embodiment is described in claim 6. In the engaged state, they can have a diameter towards the end the narrow ends of the space increasing the ends of the ledges not taken by the blocking agent, do not happen so that the last ends are enclosed directly in the carrying part. By withdrawal the blocking means creates a larger space, through which the ledge ends can get out unhindered.

Um eine unerwünschte Freigabe der Leistenenden zu vermeiden, wird vorzugsweise die in Anspruch 7 beschriebene Methode angewendet.To unwanted release of the lasts to avoid, is preferably the method described in claim 7 applied.

Ein sehr geeignetes und einfach zu handhabendes Ausführungsbeispiel ist in Anspruch 8 beschrieben. Während der Einführung und Ausdehnung des Filterelements wird der zentrale röhrenartige Körper relativ zum röhrenartigen Körper festgehalten, so dass die Eingreifmittel in der Eingreifposition verbleiben. Der äußere röhrenartige Körper kann relativ zum zentralen und zum inneren röhrenartigen Körper in distaler Richtung bewegt werden, damit sich die biegsamen Leisten ausdehnen. Der zentrale röhrenartige Körper kann relativ zum inneren röhrenartigen Körper bewegt werden, um die Eingreifmittel in die Freigabeposition zu bewegen.A very suitable and easy to use handling embodiment is described in claim 8. While the introduction and expansion of the filter element becomes the central tubular body relative to the tube-like body held so that the engaging means in the engaging position remain. The outer tubular body can be in relative to the central and inner tubular body distal direction so that the flexible strips expand. The central tubular body can be relative to the inner tubular body are moved to the engaging means in the release position move.

Durch die Herstellung des Katheters nach einer weiteren bevorzugten Eigenschaft der Erfindung, derart, dass die Leistenenden am vorderen Trageteil in abnehmbarer Weise angebracht sind, können die Eingreifmittel auf einfache Weise in die Freigabeposition bewegt werden, indem der zentrale röhrenartige Körper innerhalb des proximalen Körpers und relativ zum inneren röhrenartigen Körper bewegt wird.By making the catheter according to a further preferred property of the invention, such that the ledge ends on the front support part in a removable manner are attached, can the engaging means is easily moved to the release position by placing the central tubular body inside of the proximal body and relative to the inner tubular body is moved.

Die Erfindung wird in der folgenden Beschreibung detaillierter beschrieben, unter Bezugnahme auf die in den Zeichnungen dargestellten Ausführungsbeispiele.The invention is described in the following Description described in more detail with reference to the Exemplary embodiments shown in the drawings.

1 zeigt eine Querschnittsansicht eines Abschnitts des erfindungsgemäßen Katheters, welcher das Filterelement trägt, nachdem es für einige Zeit innerhalb der Vena cava positioniert wurde. 1 shows a cross-sectional view of a portion of the catheter according to the invention, which carries the filter element after it has been positioned within the vena cava for some time.

2 zeigt einen teilaufgerissenen Längsschnitt des Katheters aus 1. 2 shows a partially broken longitudinal cut out the catheter 1 ,

3 zeigt eine Ansicht entsprechend der 2, während die Leistenenden freigegeben werden. 3 shows a view corresponding to the 2 while the lasts of the last are released.

4 zeigt eine Ansicht entsprechend den 2 und 3, nach dem Freigeben der Leistenenden. 4 shows a view corresponding to the 2 and 3 after releasing the lasts.

Die 5–11 zeigen Querschnitte verschiedener Ausführungsbeispiele des erfindungsgemäßen Katheters an jener Stelle des Trageteils, an der die Leisten in abnehmbarer Weise angebracht sind.The 5 - 11 show cross-sections of various embodiments of the catheter according to the invention at that point of the support part at which the strips are attached in a removable manner.

In 1 wird nur der Abschnitt des distalen Endes mit dem Filterelement 6 des Katheters 1 dargestellt.In 1 only the section of the distal end with the filter element 6 of the catheter 1 shown.

Der Katheter 1 umfasst einen röhrenartigen Grundkörper 2, welcher im Fall dieses bevorzugten Ausführungsbeispiels ein äußeres röhrenartiges Element 3, ein zentrales röhrenartiges Element 4 und ein inneres röhrenartiges Element 5 umfasst. Die Elemente 4 und 5 sind in die Hohlräume (Lumen) der Elemente 3 beziehungsweise 4 aufgenommen worden. Wie weiter unten detaillierter beschrieben wird, können die röhrenartigen Elemente relativ zu einander in Längsrichtung bewegt werden.The catheter 1 comprises a tubular body 2 which, in the case of this preferred embodiment, has an outer tubular member 3 , a central tubular element 4 and an inner tubular member 5 includes. The Elements 4 and 5 are in the cavities (lumens) of the elements 3 or 4 were added. As will be described in more detail below, the tubular elements can be moved longitudinally relative to one another.

Das Filterelement 6 umfasst mehrere biegsame Leisten 7, äquidistant um den Umfang des Grundkörpers 2 herum angeordnet. Die Leisten 7 weisen gegenüberliegende Enden auf, welche mit dem vorderen Trageteil 9 beziehungsweise dem hinteren Trageteil 8 verbunden sind. Bei dem hier gezeigten Ausführungsbeispiel wurden die Leisten 7 von Wandabschnitten des äußeren röhrenartigen Elements 3 gebildet, so dass in diesem Fall das Trageteil 8 als ein im äußeren röhrenartigen Element 3 des Grundkörpers 2 integrierter Teil angenommen werden kann.The filter element 6 includes several flexible strips 7 , equidistant around the circumference of the base body 2 arranged around. The last 7 have opposite ends, which with the front support part 9 or the rear support part 8th are connected. In the embodiment shown here, the strips 7 of wall sections of the outer tubular member 3 formed so that in this case the support part 8th as an outer tubular element 3 of the basic body 2 integrated part can be adopted.

Wie in den 2–4 zu sehen ist, ist das vordere Trageteil 9 mit dem inneren röhrenartigen Element 5 verbunden. Folglich können die Trageteile 8 und 9 in Relation zueinander, aufeinander zu oder voneinander weg bewegt werden, indem die röhrenartigen Elemente 3 und 5 in Längsrichtung relativ zueinander bewegt werden. Wenn die Trageteile 8 und 9 voneinander fort bewegt werden, werden die Leisten 7 gestreckt, und wenn die Trageteile 8 und 9 aufeinander zu bewegt werden, krümmen sich die Leiste 7 nach außen wie in den 1–4 gezeigt.As in the 2 - 4 can be seen is the front support part 9 with the inner tubular element 5 connected. Consequently, the support parts 8th and 9 be moved in relation to each other, towards each other or away from each other by the tubular elements 3 and 5 be moved in the longitudinal direction relative to each other. If the carrying parts 8th and 9 the bars are moved away from each other 7 stretched, and if the supporting parts 8th and 9 are moved towards each other, the bar curls 7 outward as in the 1 - 4 shown.

Es ist offensichtlich, dass der Katheter 1 in dem Zustand in einen Patienten eingeführt wird, in dem die Trageteile 8 und 9 in gewissem Abstand voneinander gehalten werden, um die Leisten zu strecken, so dass der Katheter in Höhe des Filterelements 6 einen minimalen Durchmesser besitzt.It is obvious that the catheter 1 is inserted into a patient in the state in which the carrying parts 8th and 9 be held some distance apart to stretch the strips so that the catheter is level with the filter element 6 has a minimal diameter.

Wenn das Filterelement 6 innerhalb der Vena cava des Patienten an die richtige Position gebracht wurde, wird das innere röhrenartige Element 5 in einer proximalen Richtung in Relation zum äußeren röhrenartigen Element 3 bewegt, so dass die Leisten 7 die Wand der Vena cava 10 berühren. Deshalb bilden die nach außen gekrümmten Leisten ein Filterelement, das Thromben etc. auffangen kann.If the filter element 6 placed within the patient's vena cava, the inner tubular element 5 in a proximal direction in relation to the outer tubular member 3 moved so the ledges 7 the wall of the vena cava 10 touch. Therefore, the outwardly curved strips form a filter element that can collect thrombi, etc.

Die in den Figuren mit 11 bezeichnete Gefäßinnenwand der Vena cava 10 ist um die Leisten 7 herum angeordnet, welche an der Wand der Vena cava anliegen, so dass sie dadurch von ihr umschlossen werden. Wenn der Katheter entfernt wird, genügt es folglich nicht, die Leisten erneut zu strecken, da dies die Vena cava beschädigen würde.The one in the figures with 11 designated inner wall of the vena cava 10 is about the groin 7 arranged around, which lie against the wall of the vena cava, so that they are enclosed by it. When the catheter is removed, it is therefore not enough to stretch the groin again, as this would damage the vena cava.

Bei dem gezeigten Ausführungsbeispiel sind die mit dem Trageteil 9 verbunden Leistenenden 7 ablösbar ausgelegt worden, um solche Beschädigungen zu vermeiden. Die Enden 16 der Leisten 7 wurden durch abnehmbare Eingreifmittel an dem Trageteil 9 fixiert. Zu diesem Zweck umfasst das Trageteil 9 eine Fassung oder Aushöhlung 15 mit einem kreisförmigen Querschnitt, der solchermaßen ausgelegt ist, dass das Leistenende 16 sich frei in diese hinein und aus ihr heraus bewegen kann. Die kreisförmige äußere Wand der Fassung wurde mit einer Wölbung versehen und das Leistenende 16 mit einer darauf passenden Einkerbung. Die Sperrmittel 18, welche im Falle dieses Ausführungsbeispiels die Form eines zylindrischen Röhrenabschnitts besitzen, erstrecken sich innerhalb der Fassung 15 und lassen einen Leerraum (Lumen) in der Fassung, dessen Gestalt zu der des Leistenendes 16 komplementär ist. Befinden sich die Sperrmittel 18 wie in 2 gezeigt in der Eingreifposition, in der die Sperrmittel sich innerhalb der Fassung 15 erstrecken, ist das Leistenende 16 am Trageteil 9 befestigt, da das Profil der Einkerbung und die Wölbung ein ungehindertes Herausbewegen des Leistenendes 16 verhindern.In the embodiment shown, the are with the support member 9 connected ledge ends 7 has been designed to be removable to avoid such damage. The ends 16 the last 7 were made by removable engaging means on the support part 9 fixed. For this purpose, the support part includes 9 a version or hollowing out 15 with a circular cross-section that is designed such that the ledge end 16 can move freely in and out of it. The circular outer wall of the frame was arched and the last of the last 16 with a matching notch. The blocking agent 18 which, in the case of this exemplary embodiment, have the shape of a cylindrical tube section, extend within the socket 15 and leave an empty space (lumen) in the socket, its shape to that of the last 16 is complementary. Are the blocking agents 18 as in 2 shown in the engaged position, in which the locking means are within the socket 15 extend, the last end 16 is on the support member 9 attached, because the profile of the notch and the curvature an unimpeded moving out of the last end 16 prevent.

Wenn der Katheter entfernt werden muss, müssen die Leistenenden 16 freigegeben werden. Dies erfolgt durch die Bewegung der Sperrmittel 18, welche wie oben erwähnt mit dem inneren röhrenartigen Element 4 verbunden sind, nach rechts bezüglich dem Trageteil 9 und folglich bezüglich dem inneren röhrenartigen Element 5. Als Ergebnis entsteht innerhalb der Fassung 15 genügend Raum, so dass sich das Leistenende 16 ungehindert aus der Fassung 15 bewegen kann. Wie in 4 zu sehen ist, wird daraufhin der äußere röhrenartige Körper 3 in Relation zum inneren röhrenartigen Körper 5 in proximaler Richtung bewegt, weshalb die Leisten 7 ohne Einwirkung einer signifikanten Zugkraft aus der Fassung 15 gelöst werden und der Katheter mit dem Filterelement entfernt werden kann. Beim Zurückziehen gleiten die Leisten durch das Gewebe 11, das sich um sie herum gebildet hat, ohne es zu beschädigen.If the catheter needs to be removed, the groin ends must 16 be released. This is done by moving the locking means 18 which, as mentioned above, with the inner tubular member 4 are connected to the right with respect to the support member 9 and consequently with respect to the inner tubular member 5 , As a result emerges within the frame 15 enough space so that the last end 16 unhindered from the version 15 can move. As in 4 is then seen, the outer tubular body 3 in relation to the inner tubular body 5 moved in the proximal direction, which is why the groin 7 without the influence of a significant tractive force from the version 15 can be solved and the catheter with the filter element can be removed. When pulling back, the strips slide through the fabric 11 that has formed around them without damaging it.

Wie bezugnehmend auf die Figuren aus dem obigen deutlich wird, passen die Leistenenden 16 zum Trageteil 9, weil das Leistenende einen Abschnitt 17 umfasst, dessen Durchschnitt mit der Entfernung vom Ende, das heißt in der Figur zur rechten Seite hin, kleiner wird und weil die Sperrmittel 18 in der Eingreifposition innerhalb der Fassung 15 Raum freilassen, dessen Gestalt zu der des Abschnitts 17 komplementär ist.As is clear from the figures above, the last ends fit 16 to the carrying part 9 because the last end of a section 17 comprises, the average of which decreases with the distance from the end, that is to say to the right in the figure, and because the blocking means 18 in the engagement position within the socket 15 Leave space free, the shape of which corresponds to that of the section 17 is complementary.

Wie weiterhin in den Figuren zu erkennen ist, umfasst das vordere Trageteil 9 an seinem relativ proximalen Ende eine biegsame Lippe 19, welche federnd an den Leisten anliegt, wenn diese fixiert sind. Dadurch wird ein glatter Übergang zwischen dem Unerstützungsteil 9 und den Leisten geschaffen.As can also be seen in the figures, the front support part comprises 9 at its relative proximal end of a pliable lip 19 , which resiliently rests on the strips when they are fixed. This will make a smooth transition between the support part 9 and created the last.

Die Eingreifmittel können in vielen verschiedenen Ausführungen realisiert werden. Die 5–11 zeigen einige Möglichkeiten.The engagement means can be implemented in many different designs. The 5 - 11 show some options.

Bei dem in 5 gezeigten Ausführungsbeispiel des Katheters 20 weist das Leistenende einen Überstand 22 auf, welcher in eine Nut innerhalb der Fassung 15 des Trageteils einrastet. In der Eingreifposition nach rechts bewegt, umfassen die Sperrmittel 18 ein keilförmiges Ende 21, welches den Vorsprung 22 in die Nut gedrückt hält. Um ihn zu lösen, werden die Sperrmittel 18, wie in der Figur zu sehen, nach links bewegt, das heißt, weiter in die Fassung 15 gedrückt, wodurch der Überstand 22 aus der Nut gelöst werden kann.At the in 5 shown embodiment of the catheter 20 the last of the last shows a protrusion 22 on which in a groove within the socket 15 of the support part snaps into place. Moved to the right in the engaged position, the locking means comprise 18 a wedge-shaped end 21 giving the lead 22 pressed into the groove. To solve it, the blocking means 18 , as seen in the figure, moved to the left, that is, further into the socket 15 pressed, causing the supernatant 22 can be released from the groove.

Das in 6 gezeigte Ausführungsbeispiel des Katheters 25 korrespondiert weitgehend mit dem in 5 gezeigten. Auch hier weist das Leistenende einen Vorsprung 24 auf, welcher in eine Vertiefung in einer Wand der Fassung 15 einrastet. Die Sperrmittel 18 weisen an ihren relativ distalen Enden eine Wölbung 23 auf, mit welcher das Leistenende in die Vertiefung gedrückt gehalten wird. Um die Leistenenden zu lösen, werden die Sperrmittel 18 nach links bewegt, wodurch genügend Platz geschaffen wird, um das Leistenende freizugeben.This in 6 shown embodiment of the catheter 25 largely corresponds to that in 5 . shown Here too, the end of the last has a head start 24 on which in a recess in a wall of the socket 15 locks. The blocking agent 18 have a bulge at their relatively distal ends 23 with which the last of the last is pressed into the recess. In order to release the lasts of the ledge, the locking means 18 moved to the left, creating enough space to release the last of the last.

Bei dem Katheter 30 aus 7 weist das Leistenende ebenso eine Wölbung 26 auf, welche in eine Fassung 15 des Trageteils gedrückt wird. In diesem Fall bilden die Sperrmittel 18 eine einfache Hülle, welche den 'Ausgang' der Fassung 15 verengt, wodurch die Wölbung 26 nicht aus der Fassung 15 herausbewegt werden kann, solange die Sperrmittel 18 sich in der gezeigten Eingreifposition befinden. Durch einfaches Bewegen der Sperrmittel 18 nach rechts wird genügend Platz geschaffen, damit die Wölbung 26 passieren und das Leistenende 16 freigegeben werden kann.The catheter 30 out 7 the ledge end also has a curvature 26 on which in a version 15 of the support part is pressed. In this case, the blocking means 18 a simple shell, which is the 'exit' of the frame 15 narrowed, causing the bulge 26 not out of sorts 15 can be moved out as long as the blocking means 18 are in the engagement position shown. By simply moving the locking means 18 enough space is created to the right so that the curvature 26 happen and the last end 16 can be released.

Der in 8 gezeigte Katheter 35 umfasst Eingreifmittel, welche auf einem etwas anderen Prinzip basieren. Das Leistenende 16 weist in diesem Fall eine Wölbung 27 auf, welche in einer Vertiefung in der Fassung des Trageteils steckt. Die Sperrmittel 18 weisen jedoch ein wesentlich stärkeres keilförmiges Ende 28 auf, welches mit der komplementären Oberfläche der Fassung 15 in Verbindung steht. In dem in 8 beschriebenen Zustand wurden sowohl das Leistenende 16 als auch die Sperrmittel 18 fixiert. Um das Leistenende 16 freizugeben, werden die Sperrmittel 18 ein kurzes Stück nach rechts bewegt, wodurch das keilförmige Ende 28 jenen Abschnitt des Trageteils 9, welcher an die Fassung 15 grenzt, nach außen drückt, so dass sich die Wölbung 27 heraus bewegen kann.The in 8th shown catheter 35 includes interventions based on a slightly different principle. The last end 16 shows a curvature in this case 27 on, which is in a recess in the socket of the support part. The blocking agent 18 however, have a much stronger wedge-shaped end 28 on which matches the complementary surface of the socket 15 communicates. In the in 8th described condition were both the groin end 16 as well as the blocking agent 18 fixed. At the end of the last 16 to release the blocking agent 18 moved a short distance to the right, creating the wedge-shaped end 28 that section of the support member 9 which to the version 15 borders, pushes outwards so that the curvature 27 can move out.

Bei dem Katheter 40 aus 9 weisen die Sperrmittel 18 und das Leistenende 16 Profile auf, welche im rechten Winkel zur von links nach rechts verlaufenden Verschieberichtung der Sperrmittel 18 ineinander greifen. Diese Profile umfassen eine auf den Sperrmitteln 18 angeordnete Wölbung 29 und eine entsprechende auf dem Leistenende angeordnete Vertiefung 31. Wenn das Leistenende 16 und die Sperrmittel 18 wie in 9 gezeigt in die Fassung eingefügt wurden, ist das Leistenende 16 relativ zum Trageteil 9 fixiert. Zusammen mit den Sperrmitteln 18 kann das Leistenende frei innerhalb der Fassung bewegt werden, so dass, wenn die Sperrmittel 18 aus der gezeigten Eingreifposition nach rechts in die Freigabeposition bewegt werden, sich das Leistenende 16 parallel bewegt und folglich zusammen mit den Sperrmittel 18 aus der Fassung bewegt wird.The catheter 40 out 9 assign the blocking means 18 and the last end 16 Profiles which are at right angles to the direction of displacement of the locking means from left to right 18 mesh. These profiles include one on the blocking means 18 arranged curvature 29 and a corresponding recess arranged on the end of the last 31 , When the last end 16 and the blocking agent 18 as in 9 shown in the version is the last of the last 16 relative to the support part 9 fixed. Together with the blocking agents 18 the ledge end can be moved freely within the socket, so that when the locking means 18 the ledge end is moved from the shown engagement position to the right into the release position 16 moved in parallel and consequently together with the locking means 18 is moved out of the socket.

Bei dem in 10 gezeigten Ausführungsbeispiel des Katheters 45 weisen die Sperrmittel 18 zusätzlich eine Vertiefung 32 und die Innenwand der Fassung eine entsprechende Wölbung 33 auf. Dadurch rasten die Sperrmittel 18 zusammen mit dem Leistenende 16 mittels einer Schnappbewegung in die Fassung des Trageteils 9 ein. Wenn die Sperrmittel 18 von der gezeigten Eingreifposition in die Freigabeposition gebracht werden, muss ein gewisser Widerstand überwunden werden, um die Wölbung 33 zu passieren. Danach führen die Sperrmittel 18 das Leistenende 16 nach außen, aus dem Trageteil 9 heraus.At the in 10 shown embodiment of the catheter 45 assign the blocking means 18 additionally a deepening 32 and the inner wall of the frame has a corresponding curvature 33 on. This locks the locking means 18 together with the last of the last 16 by means of a snap movement into the holder part 9 on. If the blocking agent 18 from the shown engagement position to the release position, a certain resistance has to be overcome to the curvature 33 to happen. Then the blocking means lead 18 the last end 16 to the outside, from the carrying part 9 out.

Schliesslich wird in 11 ein Katheter 50 gezeigt, welcher Eingreifmittel umfasst, die wiederum nach einem anderen Prinzip arbeiten. Das Leistenende 16 wurde auch in diesem Fall in eine Fassung des Trageteils 9 eingefügt. In diesem Fall umfassen die Eingreifmittel eine schräg geführte Bohrung 34 im Leistenende 16 und, falls sich das Leistenende 16 im eingeführten Zustand befindet, eine Bohrung 36 im Trageteil 9, welches mit diesem Loch 34 ausgerichtet ist. Ein stabiler Draht 37 wird in diese ausgerichteten Löcher 34 und 36 eingeführt. Dieser Draht 37 bewahrt das Leistenende 16 davor, sich nach außen, aus der Fassung 15 heraus, zu bewegen.Finally, in 11 a catheter 50 shown, which includes intervention means, which in turn work on a different principle. The last end 16 was also in this case in a version of the support part 9 inserted. In this case, the engagement means comprise an obliquely guided bore 34 in the groin end 16 and, if the last end 16 is in the inserted state, a hole 36 in the carrying part 9 which with this hole 34 is aligned. A stable wire 37 is aligned in these holes 34 and 36 introduced. That wire 37 preserves the last of the last 16 before looking outwards, out of sorts 15 out to move.

Um das Leistenende 16 freigeben zu können, weist der Katheter 50 einen Zugdraht 38 auf, welcher in Richtung des proximalen Endes führt und welcher mit dem Sperrdraht 37 verbunden ist. Durch Ziehen am Zugdraht 38 am proximalen Ende wird der Sperrdraht 37 von der dargestellten Eingreifposition in die Freigabeposition bewegt, in der er mindestens aus der schrägen Bohrung 34 im Leistenende 16 entfernt wurde. Das Leistenende 16 kann sich dann frei nach außen, aus der Fassung 15, bewegen.At the end of the last 16 to be able to release the catheter 50 a pull wire 38 which leads towards the proximal end and which with the locking wire 37 connected is. By pulling the pull wire 38 at the proximal end is the barrier wire 37 from the illustrated engagement position to the release position in which it moves at least out of the oblique hole 34 in the groin end 16 was removed. The last end 16 can then move freely outwards from the socket 15 , move.

Es ist klar, dass die Erfindung viele verschiedene Ausführungsformen umfasst. Obwohl in allen Variationen der Ausführungsbeispiele das Leistenende jedesmal von einer Fassung des betreffenden Trageteils aufgenommen wird, wird der Schutzbereich der Erfindung durch die beigefügten Ansprüche definiert.It is clear that the invention is many different embodiments includes. Although in all variations of the exemplary embodiments, the last of the last each time taken from a version of the relevant support part the scope of the invention is defined by the appended claims.

Claims (9)

Katheter (1) mit einem temporären Vena-cava-Filter, welcher einen röhrenartigen Grundkörper (2) mit einem proximalen Ende und einem distalen Ende umfasst, sowie ein Filterelement (6), welches ein vorderes, mit dem Grundkörper verbundenes Trageteil umfasst sowie, in einem gewissen Abstand in Richtung des proximalen Endes befindlich, ein hinteres, mit dem Grundkörper verbundenes Trageteil (8), eine Anzahl von biegsamen, äquidistant voneinander um den Umfang des Grundkörpers herum angeordneter Leisten (7), von denen jede entgegengesetzte Enden umfasst, welche mit dem vorderen beziehungsweise hinteren Trageteil verbunden sind, und Ausdehnungsmittel, welche mindestens eines der Trageteile auf das anderen zu und von ihm weg bewegen können, um die biegsamen Leisten zu krümmen oder zu strecken, und welche am proximalen Ende gesteuert werden können, dadurch gekennzeichnet, dass die biegsamen Leisten mit mindestens einem der Trageteile durch abnehmbare Eingriffsmittel verbunden sind, welche zwischen einer Eingriffsposition, in der sie das Leistenende an dem Trageteil fixieren, und einer Freigabeposition, in der sie das Leistenende freigeben, bewegt werden können, wobei die Eingriffsmittel mit Steuermitteln in Verbindung stehen, welche zum Zweck der Bewegung der Eingriffsmittel von der Eingriffsposition in die Freigabeposition nahe dem proximalen Ende angeordnet sind.Catheter ( 1 ) with a temporary vena cava filter, which has a tubular body ( 2 ) with a proximal end and a distal end, and a filter element ( 6 ), which comprises a front support part connected to the base body and, at a certain distance in the direction of the proximal end, a rear support part connected to the base body ( 8th ), a number of flexible strips arranged equidistantly from one another around the circumference of the base body ( 7 ), each having opposite ends connected to the front and rear support members, respectively, and expansion means which can move at least one of the support members towards and away from the other to bend or stretch the flexible strips, and which can be controlled at the proximal end, characterized in that the flexible strips are connected to at least one of the support parts by removable engagement means, which between an engagement position in which they fix the strip end to the support part and a release position in which they release the strip end , can be moved, the engagement means being connected to control means which are arranged near the proximal end for the purpose of moving the engagement means from the engagement position into the release position. Katheter nach Anspruch 1, bei welchem die Eingriffsmittel für jede Leiste eine am Trageteil gebildete Fassung (15) umfassen, um das Leistenende lose aufzunehmen, sowie separate Sperrmittel (18), welche durch die Steuermittel bewegt werden können, um das Leistenende in der Fassung zu fixieren.Catheter according to Claim 1, in which the engagement means for each bar has a socket ( 15 ) to hold the end of the last loosely, as well as separate locking devices ( 18 ), which can be moved by the control means to fix the last end in the socket. Katheter nach Anspruch 2, bei welchem die Sperrmittel in der Eingriffsposition in die Fassung hineinreichen.The catheter of claim 2, wherein the locking means reach into the socket in the engaged position. Katheter nach Anspruch 3, bei welchem die Sperrmittel und das Leistenende Profile aufweisen, welche unter rechtem Winkel zur Versatzrichtung der Sperrmittel ineinander einrasten.The catheter of claim 3, wherein the locking means and the last end have profiles which are at right angles snap into the direction of offset of the locking means. Katheter nach Anspruch 4, bei welchem sich die Leistenenden zusammen mit den Sperrmitteln frei innerhalb der Fassung bewegen können.The catheter of claim 4, wherein the groin ends move freely together with the locking means within the socket can. Katheter nach Anspruch 4, bei welchem das Leistenende einen Abschnitt umfasst, dessen Durchmesser mit der Entfernung vom Ende abnimmt, und bei welchem die Sperrmittel in der Eingriffsposition Raum in der Fassung frei lassen, dessen Gestalt zu der dieses Abschnitts komplementär ist.The catheter of claim 4, wherein the groin end includes a section whose diameter increases with the distance from End decreases, and in which the locking means in the engaged position space leave free in the version, the shape of which corresponds to that of this section complementary is. Katheter nach Anspruch 2, welcher Schnappmittel (32, 33) aufweist, um die Sperrmittel in der Eingriffsposition zu halten.Catheter according to claim 2, which snap means ( 32 . 33 ) to hold the locking means in the engaged position. Katheter nach Anspruch 1, bei welchem der Grundkörper einen äußeren röhrenartigen Körper (3) mit einem Hohlraum umfasst, durch den sich ein zentraler röhrenartiger Körper (4) erstreckt, welcher ebenfalls einen Hohlraum umfaßt, durch den sich ein innerer röhrenartiger Körper (5) erstreckt, wobei das vordere Trageteil (9) mit dem inneren röhrenartigen Körper (5), das hintere Trageteil (8) mit dem äußeren röhrenartigen Körper (3) und die Eingriffsmittel mit dem zentralen röhrenartigen Körper (4) verbunden sind, und wobei die röhrenartigen Körper am proximalen Ende mit Steuermitteln verbunden sind, um die röhrenartigen Körper relativ zueinander zu bewegen.The catheter of claim 1, wherein the base body is an outer tubular body ( 3 ) with a cavity through which a central tubular body ( 4 ), which also includes a cavity through which an inner tubular body ( 5 ) extends, the front support part ( 9 ) with the inner tubular body ( 5 ), the rear support part ( 8th ) with the outer tubular body ( 3 ) and the means of engagement with the central tubular body ( 4 ), and wherein the tubular bodies at the proximal end are connected to control means for moving the tubular bodies relative to each other. Katheter nach Anspruch 8, wobei die Leistenenden in abnehmbarer Weise mit dem vorderen Trageteil verbunden sind.The catheter of claim 8, wherein the groin ends are detachably connected to the front support part.
DE69725388T 1996-07-03 1997-07-02 Catheter with provisional vena cava filter Expired - Lifetime DE69725388T2 (en)

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NL1003497A NL1003497C2 (en) 1996-07-03 1996-07-03 Catheter with temporary vena-cava filter.

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CA2209099C (en) 2006-01-31
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JPH10151205A (en) 1998-06-09
US5976172A (en) 1999-11-02
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NL1003497C2 (en) 1998-01-07
EP0815803A1 (en) 1998-01-07

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